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Six Suspect Bird Flu Patients in Igdir Turkey Hospitalized
Recombinomics Commentary
January 5, 2006
Six people have been sent to hospital in a second province in eastern Turkey with suspected bird flu, NTV commercial television reported today.
The news follows the death of two teenagers, a brother and sister, in Van hospital in eastern Turkey overnight in the first human cases of bird flu outside China and South-East Asia.
NTV said the six patients were from Igdir province on the Armenian border, just to the north of Agri province where the two dead children came from.
The above comments indicate the H5N1 in humans in Turkey is expanding. Although WHO had previously indicated all human cases were limited to two large families in Agri Province, the above report indicates there are six additional patients in Igdir Province. Turkey has filed an emergency OIE report on a H5 outbreak in chickens, turkeys, ducks, and geese in Igdir province beginning in the middle of December, the same time as the outbreak in Agri Province.
The total number of cases remains unclear. Reports yesterday indicated additional cases were being transported to Van, but the report did not say the additional cases were from Agri Province. Thus, the total numbe rof cases may be as high as 21. In any event, cases in a second province signal a larger outbreak because dead birds have also been reported in two adjacent provinces, Erzurum and Kars, in Turkey.
These four province extend into central Turkey and suggest more H5N1 is in countries adjacent to Turkey. None of the adjacent countries have filed OIE reports. New rules effective January 1, 2006 require reports of diseases that could spread into adjacent countries. It would appear that such new rules are not being observed. Poultry deaths throughout the Middle East have been reported previously, but no country as filed a report on H5N1.
The expansion of suspect cases to two provinces in Turkey is cause for concern. If these new patients also have pneumonia and bleeding gums, they are almost certainly new H5N1 victims. This large number of cases in a sparsely populated region in eastern Turkey again indicates that human transmission of H5N1 has become more efficient and cause for considerable concern.
Sequencing of new isolates, especial HA and the region encoding position 227 would be useful.
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